Anti-microbial antibodies in celiac disease: Trick or treat?

M. Papp, Ildiko Foldi, I. Altorjay, Eszter Palyu, M. Udvardy, Judit Tumpek, S. Sipka, Ilma Rita Korponay-Szabo, E. Nemes, G. Verès, Tamas Dinya, A. Tordai, H. Andrikovics, Gary L. Norman, P. Lakatos

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

AIM: To determine the prevalence of a new set of anti-glycan and anti-outer membrane protein (anti-OMP) antibodies in a Hungarian cohort of adult Celiac disease (CD) patients. METHODS: 190 consecutive CD patients [M/F: 71/119, age:39.9 (SD:14.1) years], 100 healthy, and 48 gastrointestinal controls were tested for glycan anti-Saccharomyces cerevisiae (gASCA), anti-laminaribioside (ALCA), anti-chitobioside, anti-mannobioside, anti-OMP antibodies and major NOD2/CARD15 mutations. Thirty out of 82 CD patients enrolled at the time of diagnosis were re-evaluated for the same antibodies after longstanding gluten-free diet (GFD). RESULTS: 65.9% of the CD patients were positive for at least one of the tested antibodies at the time of the diagnosis. Except anti-OMP and ALCA, antimicrobial antibodies were exclusively seen in untreated CD; however, the overall sensitivity was low. Any glycan positivity (LR+: 3.13; 95% CI: 2.08-4.73) was associated with an increased likelihood ratio for diagnosing CD. Significant correlation was found between the levels of anti-glycan and anti-endomysial or anti-transglutaminase antibodies. Anti-glycan positivity was lost after longstanding GFD. Anti-glycan antibody titers were associated with symptoms at presentation, but not the presence of NOD2/CARD15 mutations. Patients with severe malabsorption more frequently had multiple antibodies at diagnosis (P = 0.019). CONCLUSION: The presence of anti-glycan antibodies in CD seems to be secondary to the impaired small bowel mucosa which can lead to increased antigen presentation. Furthermore, anti-glycan positivity may be considered an additional marker of CD and dietary adherence.

Original languageEnglish
Pages (from-to)3891-3900
Number of pages10
JournalWorld Journal of Gastroenterology
Volume15
Issue number31
DOIs
Publication statusPublished - 2009

Fingerprint

Celiac Disease
Polysaccharides
Anti-Idiotypic Antibodies
Antibodies
Gluten-Free Diet
Membrane Proteins
Mutation
Transglutaminases
Antigen Presentation
Saccharomyces cerevisiae
Mucous Membrane

Keywords

  • Anti-outer membrane protein antibody
  • Anti-Saccharomyces cerevisiae antibodies
  • Bacterial translocation
  • Celiac disease
  • Crohn's disease
  • Gluten-free diet
  • Glycans
  • NOD2/CARD15
  • Presenting symptoms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Anti-microbial antibodies in celiac disease : Trick or treat? / Papp, M.; Foldi, Ildiko; Altorjay, I.; Palyu, Eszter; Udvardy, M.; Tumpek, Judit; Sipka, S.; Korponay-Szabo, Ilma Rita; Nemes, E.; Verès, G.; Dinya, Tamas; Tordai, A.; Andrikovics, H.; Norman, Gary L.; Lakatos, P.

In: World Journal of Gastroenterology, Vol. 15, No. 31, 2009, p. 3891-3900.

Research output: Contribution to journalArticle

Papp, M. ; Foldi, Ildiko ; Altorjay, I. ; Palyu, Eszter ; Udvardy, M. ; Tumpek, Judit ; Sipka, S. ; Korponay-Szabo, Ilma Rita ; Nemes, E. ; Verès, G. ; Dinya, Tamas ; Tordai, A. ; Andrikovics, H. ; Norman, Gary L. ; Lakatos, P. / Anti-microbial antibodies in celiac disease : Trick or treat?. In: World Journal of Gastroenterology. 2009 ; Vol. 15, No. 31. pp. 3891-3900.
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abstract = "AIM: To determine the prevalence of a new set of anti-glycan and anti-outer membrane protein (anti-OMP) antibodies in a Hungarian cohort of adult Celiac disease (CD) patients. METHODS: 190 consecutive CD patients [M/F: 71/119, age:39.9 (SD:14.1) years], 100 healthy, and 48 gastrointestinal controls were tested for glycan anti-Saccharomyces cerevisiae (gASCA), anti-laminaribioside (ALCA), anti-chitobioside, anti-mannobioside, anti-OMP antibodies and major NOD2/CARD15 mutations. Thirty out of 82 CD patients enrolled at the time of diagnosis were re-evaluated for the same antibodies after longstanding gluten-free diet (GFD). RESULTS: 65.9{\%} of the CD patients were positive for at least one of the tested antibodies at the time of the diagnosis. Except anti-OMP and ALCA, antimicrobial antibodies were exclusively seen in untreated CD; however, the overall sensitivity was low. Any glycan positivity (LR+: 3.13; 95{\%} CI: 2.08-4.73) was associated with an increased likelihood ratio for diagnosing CD. Significant correlation was found between the levels of anti-glycan and anti-endomysial or anti-transglutaminase antibodies. Anti-glycan positivity was lost after longstanding GFD. Anti-glycan antibody titers were associated with symptoms at presentation, but not the presence of NOD2/CARD15 mutations. Patients with severe malabsorption more frequently had multiple antibodies at diagnosis (P = 0.019). CONCLUSION: The presence of anti-glycan antibodies in CD seems to be secondary to the impaired small bowel mucosa which can lead to increased antigen presentation. Furthermore, anti-glycan positivity may be considered an additional marker of CD and dietary adherence.",
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T2 - Trick or treat?

AU - Papp, M.

AU - Foldi, Ildiko

AU - Altorjay, I.

AU - Palyu, Eszter

AU - Udvardy, M.

AU - Tumpek, Judit

AU - Sipka, S.

AU - Korponay-Szabo, Ilma Rita

AU - Nemes, E.

AU - Verès, G.

AU - Dinya, Tamas

AU - Tordai, A.

AU - Andrikovics, H.

AU - Norman, Gary L.

AU - Lakatos, P.

PY - 2009

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N2 - AIM: To determine the prevalence of a new set of anti-glycan and anti-outer membrane protein (anti-OMP) antibodies in a Hungarian cohort of adult Celiac disease (CD) patients. METHODS: 190 consecutive CD patients [M/F: 71/119, age:39.9 (SD:14.1) years], 100 healthy, and 48 gastrointestinal controls were tested for glycan anti-Saccharomyces cerevisiae (gASCA), anti-laminaribioside (ALCA), anti-chitobioside, anti-mannobioside, anti-OMP antibodies and major NOD2/CARD15 mutations. Thirty out of 82 CD patients enrolled at the time of diagnosis were re-evaluated for the same antibodies after longstanding gluten-free diet (GFD). RESULTS: 65.9% of the CD patients were positive for at least one of the tested antibodies at the time of the diagnosis. Except anti-OMP and ALCA, antimicrobial antibodies were exclusively seen in untreated CD; however, the overall sensitivity was low. Any glycan positivity (LR+: 3.13; 95% CI: 2.08-4.73) was associated with an increased likelihood ratio for diagnosing CD. Significant correlation was found between the levels of anti-glycan and anti-endomysial or anti-transglutaminase antibodies. Anti-glycan positivity was lost after longstanding GFD. Anti-glycan antibody titers were associated with symptoms at presentation, but not the presence of NOD2/CARD15 mutations. Patients with severe malabsorption more frequently had multiple antibodies at diagnosis (P = 0.019). CONCLUSION: The presence of anti-glycan antibodies in CD seems to be secondary to the impaired small bowel mucosa which can lead to increased antigen presentation. Furthermore, anti-glycan positivity may be considered an additional marker of CD and dietary adherence.

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KW - NOD2/CARD15

KW - Presenting symptoms

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